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Individual

BRIAN DAVID KANYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2200 OAKENWALD DR, LONG BEACH, IN 46360-1527
(219) 874-9079
Mailing address
2200 OAKENWALD DR, LONG BEACH, IN 46360-1527
(219) 874-9079

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05001725A
IN

Other

Enumeration date
06/27/2007
Last updated
07/08/2007
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